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Why Americans Spend So Much on Health Care–In 12 Charts

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Re: Why Americans Spend So Much on Health Care–In 12 Charts

#51

Post by sykhic »

swarnie_ wrote: post #10

Please can someone explain the USA's lack of free healthcare to me? Every time i see it suggested or attempted its immediately sabotaged by just about everyone. The NHS is one of the greatest things to come out the UK but you guys seem so opposed to the notion.

We Americans have a pathological fear of socialism and since the 1980s it's been ingrained in the collective psyche of the nation that government is bad. You'll hear people talk about how government can't do anything right but we have the greatest military in the world. Such contradictions are endemic to the right leaning people of the country. Left leaning people of the country have a differing set of contradictions.

There is also a coupled fear of a poor person getting something they don't deserve. This has foundations in religion and in the development of the nation. There was a time (over a hundred years ago) when a man(family) could do it on their own and live off the land. This inculcated in us the idea that being poor is associated with being a slouch. Such a time has long since passed but that ethos is still in the collective consciousness.

There is also a pathological fear of taxes. It is widely believed that government is always more inefficient than a privatized solution. We had a Vice-Presidential candidate laugh at the notion that paying taxes is patriot and this while her son was in the military during a time of war! A lot of people think of themselves as some sort of Daniel Boone character that can do it on their own if only government got out of the way.

We do have a national healthcare system for elderly, members of the military, and most children. Everyone else can fend for themselves.

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#52

Post by peterwwillis »

howard941 wrote: post #12

> Consumers, meanwhile, buoyed by insurance and tax breaks, have little idea how much they are really spending and little incentive to know underlying costs. Almost weekly there's another post showing that consumers literally cannot find out costs usually because the provider cannot supply it. It's time to put a stake in the heart of the recurring blame-the-consumer trope.

I have a reason to partly blame consumers.

Recently I went in for a consult to see about an operation. Before the consult, they asked for a pee sample. After the consult I got a bill, including the lab work. I never got the operation.

The doctor never needed that lab for the consult. I don't think they even performed it that day. They just threw an extra step into the procedure, knowing that most patients would just accept it rather than interrogate the doctor or nurse as to why this was needed. The nicest way to view this is the office is operating with unnecessary procedures that drive up cost. A less charitable interpretation is they're jacking up their fees.

The blame falls on me here because I put blind faith in the doctor's office and did not fully investigate everything being done and approve or deny things based on my questions.

Now, do I think I should have to do this? Hell no. I'm not qualified to speak to their procedures. But the only way I can see doctors change how they operate is to start demanding it, in addition to regulatory change to provide a fee breakdown before doing anything. I know this would probably only make everything more expensive and slower, but I don't have a better idea. Hopefully somebody else does.

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#53

Post by nicoburns »

rayiner wrote: post #15
komali2 wrote: post #8

Do republican politicians, and others in charge of maintaining this healthcare farce we have, have some sort of training in "convince the downtrodden to vote for things that make their lives harder" or is it just something natural? I say this as a Wisconsin emigrant that watched my home state shoot itself in the face time and time and time again.

Do democratic politicians have some sort of training in maintaining the farce that more things should be handled by government, when governments in Illinois, California, New York, etc.--democratic strongholds where Republicans cannot be pointed to as the scapegoats--are on the verge of bankruptcy? I don't think, deep down, republicans think the current system is better. They just don't trust whatever replaces it won'…

The European countries invest in public services. And have no qualms collecting taxes to pay for them...

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#55

Post by yardie »

koolba wrote: post #19
swarnie_ wrote: post #10

Please can someone explain the USA's lack of free healthcare to me? Every time i see it suggested or attempted its immediately sabotaged by just about everyone. The NHS is one of the greatest things to come out the UK but you guys seem so opposed to the notion.

The abridged version is that they were working on it but the head of Kaiser convinced Nixon that private health insurance was a better option. Fast forward a few decades and there is too much at stake for the companies providing the care^insurance for a graceful change. Large companies also don't give a hoot because they're able to offer corporate self-insured plans which constitutes a competitive advantage against s…

The ACA isn't all bad. One thing it did do was open the market to more providers. Prior to that every state had their own insurance companies (ie. BCBS-FL, BCBS-VA, BCBS-WA). And if you wanted it there were maybe 2-3 companies you could choose from.

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#56

Post by chimeracoder »

gameswithgo wrote: post #25
WillPostForFood wrote: post #16

Earlier quoted context omitted.

I agree, but I think they are talking about a different aspect of "not knowing". Which is, I get health coverage from my employer, I go to the doctor, I get some sort of bill that seems high but not crazy, I assume that is the cost of visit. But I am not seeing the transactions behind the scene between doctor/insurer/employer that may be several times what I am directly out of pocket, but pay indirectly.

there are other kinds of problems. You are in the hospital, you feel queasy after surgery, nurse asks if you would like medication for that. "how much is it?" If you even think to ask that, usually they will not know, and can't or will not find out for you. So you can't make a rational decision about whether to deal with the discomfort or not. Similarly, doctors often won't know the cost difference between various me…

> there are other kinds of problems. You are in the hospital, you feel queasy after surgery, nurse asks if you would like medication for that. "how much is it?" If you even think to ask that, usually they will not know, and can't or will not find out for you. So you can't make a rational decision about whether to deal with the discomfort or not.

followed by

> One might conclude that private, free markets don't make sense in this domain at all, perhaps.

is an odd conclusion to draw, since the agent primarily responsible for the inability for providers to provide transparent prices to privately insured patients is, ironically, Medicare.

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#57

Post by oconnor663 »

swarnie_ wrote: post #10

Please can someone explain the USA's lack of free healthcare to me? Every time i see it suggested or attempted its immediately sabotaged by just about everyone. The NHS is one of the greatest things to come out the UK but you guys seem so opposed to the notion.

The direct answer to your question is that it's a complicated historical thing, where American doctors in the 1950's wanted to retain more control over their practices and happened to have the political power to make that happen.

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#58

Post by malvosenior »

knuththetruth wrote: post #50
malvosenior wrote: post #31

Earlier quoted context omitted.

So the democrats are not to blame for implementing it? I don't see how you can single out any particular party for this situation and if I had to, I'd go with the people that actually jacked up my premiums (democrats).

Oh, they’re entirely to blame and I’m just as angry as anyone for them furthering this broken system. But their choice of doing so was guided by right-wing ideology. The Democratic Party is a center-right party. You might not be able to single out any one party for this problem, but you can certainly indict those who further this kind of thinking in the face of its demonstrable moral and economic failure.

I'm sorry but the sheer amount of regulation around healthcare is not a right-wing ideology. Let's get the free market in here and watch costs come crashing down. Do away with mandatory coverage, subscription windows, the government run "marketplace" and costs will come down. There's nothing right-wing about any of those features.

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#59

Post by bepotts »

komali2 wrote: post #8

Do republican politicians, and others in charge of maintaining this healthcare farce we have, have some sort of training in "convince the downtrodden to vote for things that make their lives harder" or is it just something natural? I say this as a Wisconsin emigrant that watched my home state shoot itself in the face time and time and time again.

I don't understand how the "downtrodden" who rejects help from the government is somehow naive, but the billionaire who votes to have his taxes increased is somehow smart, noble, and a patriot. At the end of the day everyone votes for the policy initiatives that they prefer - whether the program is trying to help them or not.

The thing about lots of "downtrodden" people is they want opportunity - not support from the government. They want to be able to stand on their two feet to support their wives and kids - not to have Warren Buffet pay for their meals.

Re: Why Americans Spend So Much on Health Care–In 12 Charts

#60

Post by andybak »

malvosenior wrote: post #13
komali2 wrote: post #8

Do republican politicians, and others in charge of maintaining this healthcare farce we have, have some sort of training in "convince the downtrodden to vote for things that make their lives harder" or is it just something natural? I say this as a Wisconsin emigrant that watched my home state shoot itself in the face time and time and time again.

You do realize that it was under democratic leadership that healthcare costs shot up so much. Obamacare increased my monthly payment almost 2X.

1. The discussion is about US healthcare costs compared to the rest of the world which is different to your monthly payments.

2. "Obamacare" seems to an outsider to have been a hellish compromise - the only thing that could get passed considering the political balance of power at the time. It was far from the legislation that was originally intended - and that even legislation (what was deemed politically possible in advance) is probably far from what would be needed to fix the US healthcare system.

So it's entirely possible you ended up with a terrible outcome instead of the merely inadequate outcome that might have transpired in a different climate.

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